Current state-of-the-art of concomitant chemoradiation in cervical carcinomas

Despite screening programs, cervical carcinoma remains a major health problem throughout the world. Until recently pelvic radiation has been the standard therapy for advanced disease with overall five-year survival rates of 50%. Recently, five randomized trials demonstrated a significant survival advantage for the concomitant administration of radiotherapy and cisplatin-based chemotherapy. Although the trials vary somewhat in terms of stage of disease, dose of radiation, and schedule of radiation and cisplatin, they all demonstrated a significant survival benefit for the combined approach. Congruent to these findings are results from a meta-analysis based on the data from 19 trials with 4,580 randomized patients. The absolute increase in progression-free and overall survival was 16% and 12%, respectively. Contrary to these findings is the result of the National Cancer Institute of Canada (NCCI) trial. Despite that result cisplatin-based concomitant chemoradiotherapy has become the standard treatment of locally advanced cervical cancer.